Song Taejong, Lee San-Hui, Kim Woo Young, Heo Eun Jin, Kim Tae-Joong
Department of Obstetrics and Gynecology, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
Gynecol Obstet Invest. 2017;82(5):468-474. doi: 10.1159/000452663. Epub 2016 Nov 24.
To determine whether opportunistic salpingectomy in patients undergoing laparoscopic myomectomy has any deleterious effects on ovarian reserve and surgical risk.
We performed a retrospective review of patients who had no desire for future child bearing and who were undergoing laparoscopic myomectomy for symptomatic myomas at 4 institutions. Among them, 41 patients concurrently underwent opportunistic salpingectomy (the opportunistic salpingectomy group) and 65 patients did not undergo salpingectomy at the time of laparoscopic myomectomy (the no-salpingectomy group). The primary and secondary outcome measures were change of ovarian reserve determined by the rate of decline in the anti-Müllerian hormone (AMH) level from before surgery to 3 months post-surgery, and surgical outcomes.
Baseline characteristics were similar between groups. There were also no differences in surgical outcomes, such as operative time, operative bleeding, hospital stay, or complications between groups. The decline rate in AMH was 18.6% (interquartile range (IQR) 2.6-46.8%) in the opportunistic salpingectomy group and 10.4% (IQR 2.6-46.8%) in the no-salpingectomy group, with no significant difference between groups (p = 0.593).
Opportunistic salpingectomy at the time of laparoscopic myomectomy was not associated with negative effects on ovarian reserve or increased surgical risk.
确定接受腹腔镜子宫肌瘤切除术的患者进行择期输卵管切除术是否会对卵巢储备和手术风险产生任何有害影响。
我们对4家机构中那些不打算未来生育且因有症状的肌瘤而接受腹腔镜子宫肌瘤切除术的患者进行了回顾性研究。其中，41例患者同时接受了择期输卵管切除术（择期输卵管切除术组），65例患者在腹腔镜子宫肌瘤切除术时未进行输卵管切除术（未行输卵管切除术组）。主要和次要结局指标是通过术前至术后3个月抗苗勒管激素（AMH）水平下降率确定的卵巢储备变化以及手术结局。
两组的基线特征相似。两组在手术结局方面也没有差异，如手术时间、术中出血、住院时间或并发症。择期输卵管切除术组的AMH下降率为18.6%（四分位间距（IQR）2.6 - 46.8%），未行输卵管切除术组为10.4%（IQR 2.6 - 46.8%），两组之间无显著差异（p = 0.593）。
腹腔镜子宫肌瘤切除术时进行择期输卵管切除术与对卵巢储备的负面影响或手术风险增加无关。
